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General NPI Number Information
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NPI Number | 1134259815
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Entity Type | Individual
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Provider Name | NADIA NICOLE LESLIE ATC,LAT
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 1 THUNDERBIRD CIR ATHLETICS DEPARTMENT
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City | HOBBS
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State | NM
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Zip | 88240-0200
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Country | US
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Telephone | 575-492-2745
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Fax |
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Provider Business Mailing Address
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Address Line | 125 E GREEN ACRES DR
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City | HOBBS
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State | NM
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Zip | 88240-4426
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Country | US
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Telephone | 915-731-5302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT2942
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 533
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License Number State | NM
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